RESERVOIR RESOURCES PLLC NPI 1932791571

NPI Information

NPI: 1932791571
Provider Name: RESERVOIR RESOURCES PLLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
2650 W MONTROSE AVE STE 207
CHICAGO, IL
ZIP 60618
Phone: (708) 431-1504
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RESERVOIR RESOURCES PLLC is a mental health counselor in Chicago, IL. RESERVOIR RESOURCES PLLC NPI is 1932791571. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2650 W MONTROSE AVE STE 207
CHICAGO, IL
ZIP 60618-674
Phone: (708) 431-1504

The provider's authorized official is Joy E Eshleman .
The authorized official title is Owner and has the following contact phone number (872) 201-1290.

The enumeration date for this NPI number is 2/4/2021 and was last updated on 4/2/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1255416046	OTHER		NPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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